By: Kellsey Reed RDN, LDN, PatientsLikeMe Contributor
When it comes to managing diabetes and chronic kidney disease, there is so much conflicting information out there. One website may tell you to only eat white bread and grilled chicken, while another website says white bread is bad for diabetes. Many websites will also tell you that a diabetes-friendly diet totally conflicts with a kidney-friendly diet. With all of this conflicting information, where do you even start?! With newer research, we know that following a kidney-friendly and diabetes-friendly diet can go hand in hand!
Back to basics
Before we jump into how to balance blood sugars with CKD, it’s important to know the basics. Diabetes is one of the leading causes of chronic kidney disease. Diabetes can also be a complication of chronic kidney disease too. Therefore it is so important to balance your blood sugars when you are diagnosed with kidney disease.
In order to know how to eat for your diabetes and CKD, it’s important to know about your labs first. You can look at your bloodwork to see if your blood sugars are within range by checking your blood glucose levels and hemoglobin A1C levels:
Blood glucose level: this test measures the amount of sugar in your blood at any given time
Hemoglobin A1C level: this test measures your blood glucose levels over a 2-3 month period
According to the CDC, a fasting blood sugar level of 99 mg/dL or lower is normal, 100 to 125 mg/dL indicates you have prediabetes, and 126 mg/dL or higher indicates you have diabetes. An A1C below 5.7% is normal, between 5.7 and 6.4% indicates you have prediabetes, and 6.5% or higher indicates you have diabetes. By knowing your numbers and the standard ranges, you can know how to move forward in a healthy way with your diabetes and CKD.
You may find your blood glucose level on your comprehensive metabolic panel or CMP. If you do not see these on your lab report, you can ask your doctor to check these levels at your next scheduled lab appointment.
Carbohydrates and blood sugars
Now that you know what your blood sugar labs mean, it’s important to talk about carbohydrates. Carbohydrates are a macronutrient found in certain foods that raise your blood glucose levels. Carbohydrates are starches, fiber, and sugars. Foods high in carbohydrates are foods like grains (bread, rice, crackers, pasta, cereals, bagels, etc.), fruits, starchy vegetables (carrots, potatoes), and beans. Foods like pastries, baked goods, sodas, and candy are also examples of high carbohydrate foods but are not recommended in excess on a kidney-friendly and diabetic-friendly diet.
When you eat foods with carbohydrates in them, your body breaks down the carbohydrates and uses them as energy. This bodily process is necessary for us. It allows us to do everyday things! No, a low carbohydrate diet is not necessary for your diabetes and kidney health, despite what you may have read online. Our bodies actually need enough carbohydrates each day to function!
With that being said, sometimes, when you eat too many carbohydrates, your body may have trouble processing them and you may experience high blood sugar or hyperglycemia. The opposite, or hypoglycemia, can also occur when you don’t eat enough carbohydrates. That is why it is so important to have balanced meals and snacks to help control your blood sugar levels with CKD.
Carbohydrate-rich foods to choose more often are:
- Starchy vegetables
- Fruits
- Beans
- Whole grains
Carbohydrate-rich foods to choose less often are:
- Baked goods
- Pastries
- Soda
- Candy or sweets
How to balance blood sugars when you have diabetes
When it comes to managing diabetes and kidney disease, balance is key. Eating balanced meals and snacks can help to keep your blood sugars within normal ranges, and it can help to protect your kidneys too. Studies show that combining foods with carbohydrates with foods with protein and fiber can help to better balance blood sugars. Fiber is especially important for blood sugar management, as it is for kidney health. Choosing whole grains can help you get in more fiber each day and therefore help manage your diabetes and CKD too.
Here is one example to demonstrate how different nutrients affect your blood sugars: If you have a piece of bread by itself, your blood sugar levels will rise a certain amount. But, if you have a piece of bread with peanut butter and celery sticks, your blood sugar levels may not rise as much.
In order to have balanced blood sugars when you have chronic kidney disease, try pairing your carbohydrate foods with protein, fat, and fiber foods. Here are some examples:
- With your pasta → add salmon for protein and mushrooms and arugula for more fiber
- With your rice → add tofu for protein and brussels sprouts for more fiber
- With your cereal → add walnuts and sunflower seeds for more protein and fiber
- With your crackers → add peanut butter for protein and celery for more fiber
- With your fruit → add pumpkin seeds for protein and radishes for more fiber
- With your beans → add tofu for protein and onions and peppers for more fiber
Resources:
- https://www.cdc.gov/diabetes/basics/getting-tested.html#:~:text=A%20fasting%20blood%20sugar%20level,higher%20indicates%20you%20have%20diabetes.
- https://www.hsph.harvard.edu/nutritionsource/carbohydrates/
- https://my.clevelandclinic.org/health/articles/15416-carbohydrates
